Regional myocardial lidocaine concentration following continuous intravenous infusion early and later after myocardial infarction

Journal Article · Wed Sep 01 04:00:00 EDT 1982 · Am. J. Cardiol.; (United States)

DOI:https://doi.org/10.1016/0002-9149(82)90315-0· OSTI ID:6646202

Zito, R A; Caride, V J; Holford, T; Zaret, B L

The regional concentration of lidocaine using a double constant infusion technique (250 micrograms/kg/min x 15 minutes followed by 35 micrograms/kg/mg/min x 120 minutes) was studied immediately (2 hours) in seven dogs and 24 hours (six dogs) after myocardial infarction. Tissue levels were determined by gas chromatography and related to regional myocardial blood flow as determined by the radioactive microsphere technique in multiple samples. At 2 hours after infarction a significantly higher lidocaine concentration (4.1 +/- 0.42 micrograms/g) was found in zones with greatly reduced blood flow (regional myocardial blood flow less than 0.2 ml/min per g) when compared with that (2.6 +/- 0.19 micrograms/g) in zones with normal blood flow (regional myocardial blood flow greater than 0.8 ml/min per g) (p less than 0.01). In contrast, in the 24 hour model the opposite situation was observed. Although the concentration of lidocaine in the infarct zone was substantial, a significant decline in lidocaine tissue concentration was found in the zones of lowest blood flow (regional myocardial blood flow less than 0.2 ml/min per g) when compared with that in normal zones (1.76 +/- 0.21 versus 3.38 +/- 0.21 micrograms/g, p less than 0.001). In addition, no significant differences in lidocaine concentrations were found between endocardium and epicardium in any of the groups other than those related to regional myocardial blood flow. Thus, with the double constant infusion technique, lidocaine reached normal and ischemic myocardium in concentrations equivalent to therapeutic plasma concentrations, even in lower infarct blood flow zones, with no significant differences between endocardium and epicardium. Of perhaps greater significance, the age of the ischemic insult is an important determinant of lidocaine tissue distribution in infarcted myocardium.

• Research Organization: Department of Medicine, Yale University School of Medicine, New Haven, CT
• OSTI ID: 6646202
• Journal Information: Am. J. Cardiol.; (United States), Journal Name: Am. J. Cardiol.; (United States) Vol. 50:3; ISSN AJCDA
• Country of Publication: United States
• Language: English

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59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
AGE DEPENDENCE
ALKALOIDS
ANIMALS
BIOCHEMISTRY
BLOOD FLOW
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CHEMISTRY
DISEASES
DISTRIBUTION
DOGS
HEART
ISCHEMIA
ISOTOPES
MAMMALS
MICROSPHERES
MUSCLES
MYOCARDIAL INFARCTION
MYOCARDIUM
ORGANIC COMPOUNDS
ORGANS
PATHOLOGY
PHARMACOLOGY
RADIOISOTOPES
TISSUE DISTRIBUTION
VASCULAR DISEASES
VERTEBRATES